Your Plan Explained UnitedHealthcare Senior Supplement Plan

Transcription

1 Your Plan Explained UnitedHealthcare Senior Supplement Plan Important coverage information.

2 Join a Leader. UnitedHealthcare. With over 25 years of experience, UnitedHealthcare is one of the nation s largest providers of health care coverage for older adults. Nationally, we serve one in five people eligible for Medicare. 1 We know that choosing the right health care coverage is a big decision. It involves looking at the costs, benefits, access to providers and so much more. UnitedHealthcare is dedicated to helping you get the most out of your health care dollar, so you can have confidence in your plan choice. Introducing the UnitedHealthcare Senior Supplement Plan. Hospital Doctors Additional Programs Your plan sponsor has chosen to offer its Medicare-eligible retirees the UnitedHealthcare Senior Supplement plan. This plan provides the flexibility needed to keep health care decisions in your hands, including what doctors to visit. Benefits are provided for covered health services received from any doctor or other licensed medical professional that accepts Medicare. This plan pays some or all of the costs not covered by Original Medicare. The Senior Supplement Plan Explained. The Senior Supplement plan is a medical plan for Medicare-eligible retirees and is available only through a plan sponsor. You must be enrolled in Medicare Parts A and B to be eligible to enroll in this plan. If you re not sure you are enrolled in Medicare Parts A and B, you can check with your local Social Security office. The Senior Supplement plan acts as a supplement to your existing Medicare Part A (hospital) and Part B (doctor and outpatient care) coverage, helping to pay for some or all of the costs that Original Medicare does not cover. The plan provides coverage similar to federal Medicare supplement plans, but it may also cover state-mandated benefits that are not covered under Medicare. The Senior Supplement plan is different from Medicare Advantage plans. With Medicare Advantage plans members receive their Medicare Part A and Part B benefits through the plan. With a Senior Supplement plan, eligible Part A and Part B benefits are paid by Original Medicare as the primary payor. The Senior Supplement plan provides coverage as the secondary payor for benefit amounts that remain after Original Medicare has paid. Prescription Drug Coverage. Your plan sponsor has selected the UnitedHealthcare MedicareRx for Groups (PDP) plan for your prescription drug coverage. You can find additional information on the UnitedHealthcare MedicareRx for Groups plan in your enrollment kit. 2 3

3 Additional Programs. Your plan provides the same coverage as Medicare Parts A and B, plus many additional programs that contribute to your health and wellness. They may include: NurseLine SM Services Speak with a registered nurse, 24 hours a day, 7 days a week. Discuss your health and diet. Review or discuss your medications. Receive information about illnesses and injuries. Get tips on working with your doctor. Solutions for Caregivers Providing care for a loved one can be demanding and overwhelming. This plan gives you access to Solutions for Caregivers a program that supports you, your family and your loved ones. Five Great Reasons to Choose the UnitedHealthcare Senior Supplement Plan Help controlling your health care costs UnitedHealthcare is committed to helping you control your health care costs. This plan helps limit your out-of-pocket expenses by covering many of the costs that Original Medicare doesn t cover. Flexibility We understand that your choice of doctors, hospitals and other health care providers is important. With this plan, you have the freedom to choose any doctor or hospital anywhere in the country that accepts Medicare. Additional programs that make a difference Additional programs that contribute to your health and wellness are available with this plan. Some examples include a fitness program, health and well-being programs, a caregiver program and NurseLine SM Services. Dedicated Customer Service We have created a dedicated customer service team that has been trained on your specific group-sponsored plans. With one simple phone call, you can get answers to all your health plan benefit questions. The convenience of one company When you choose this plan, as well as the UnitedHealthcare MedicareRx for Groups plan, you get the convenience of having both your health care coverage and your prescription drug coverage with one company UnitedHealthcare. Services provided by Solutions for Caregivers include: On-site assessment and development of a personalized care plan for you or your loved one. Unlimited phone access to a Care Specialist who can provide counsel on individual, medical, safety, emotional and social needs. Connections with professionals, including home health aides, nurses, lawyers and financial advisors. SilverSneakers Fitness Program Stay physically fit and active with the SilverSneakers Fitness Program. This fitness program is available to you at no additional cost. With the SilverSneakers Fitness Program you ll receive: A basic fitness center membership at more than 11,000 participating locations. Access to all amenities, programs and services that are standard with a basic fitness center membership. Many women-only locations, including Curves, are available nationwide. Nationwide access to any participating fitness location (find locations at If the nearest participating location is 15 miles or more away from your home, you can register for the SilverSneakers Steps program. This is a personalized program that provides tools such as resistance bands, exercise DVDs and how-to material to help you measure, track and increase your daily activity. 4 5

4 Frequently Asked Questions. 1. Will I have to change doctors if I select the UnitedHealthcare Senior Supplement plan? With this plan you can go to any doctor or hospital that accepts Medicare. As long as your doctor accepts Medicare you will not have to change doctors. 2. What are the costs under the plan? Specifics about what you pay and plan benefits can be found in the Plan Summary. 3. Do I need to call for prior authorization of service? No prior authorization is required for any services covered under the plan. 4. Are pre-existing conditions covered? Yes. Medicare-covered conditions are covered by the plan with no limitations for pre-existing conditions or waiting periods. 5. Does the plan include benefits for prescriptions or vision care? Your retiree medical plan may include supplemental coverage for vision care and you will automatically be enrolled into the UnitedHealthcare MedicareRx (PDP) plan. 6. When enrolled in the plan, do I have to continue paying my Medicare Part B monthly premiums? Yes. You must be enrolled in Medicare Part A and Part B to be eligible to enroll in this plan. If you re not sure you are enrolled, check with your local Social Security office. You must continue paying your Medicare Part B premium to keep your coverage under this group-sponsored plan. If you stop your payments, you will be disenrolled from this plan. What Happens After You Enroll. 1. UnitedHealthcare will make sure you are eligible for the plan. 2. In about 4-6 weeks, you will receive your new ID card for medical coverage. You will also receive your member ID card for prescription drug coverage in a separate mailing. 3. Once you are officially enrolled in the plan, you will receive a Welcome Kit with complete details about the benefits and services of your new health plan. 4. On your effective date, you can begin using your new ID card to enjoy your benefits and services. Questions? Call Customer Service: , TTY a.m. 8 p.m. local time, 7 days a week 6 7

5 UnitedHealth Group Annual Report NurseLine SM nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor s care. NurseLine services are not an insurance program and may be discontinued at any time. Solutions for Caregivers assists in coordinating community and in-home resources. The final decision about your care arrangements must be made by you. In addition, the quality of a particular provider must be solely determined and monitored by you. Information provided to you about a particular provider does not imply and is in no way an endorsement of that particular provider by Solutions for Caregivers. The information on and the selection of a particular provider has been supplied by the provider and is subject to change without written consent of Solutions for Caregivers. SilverSneakers is a registered mark of Healthways, Inc. Healthways, Inc., is an independent company. The SilverSneakers program is made available as part of this plan s benefits to those insured through this plan. Neither AARP nor UnitedHealthcare endorse or are responsible for the services or information provided by this program. Always consult your physician before you begin SilverSneakers or any physical fitness program. This is not a Medicare Supplement plan. This is an employer group retiree plan and may provide coverage that is different from a Medicare Supplement plan. UnitedHealthcare Senior Supplement group retiree plans are underwritten by UnitedHealthcare Insurance Company, a private insurance company not connected with or endorsed by the U.S. Government or the federal Medicare program. In New York, the plans are called UnitedHealthcare Retiree Benefit Plans and are underwritten by UnitedHealthcare Insurance Company of New York. Senior Supplement plans may not be available in all states. UnitedHealthcare is part of the UnitedHealth Group family of companies. UHEX12SS _000